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This Thoracotomy Is Kicking My Butt

cinnamonsmile
Posts: 1042
Joined: Dec 2010

I usually have lots of intense pains after surgeries. I expect it. But pulling the plum sized mass out of my left lung with the thoracotomy is really kicking me and the pain has got me down.

The pain is so intense in the back, the side of my chest, and the lower chest/lung. This surgery is known for being incredibly painful and the surgeon had to work on areas that are already in pain from the BMX with node removal.

I improved a bit over Sunday morning when I woke up (that is when I went thru my first night at home and didn't set an alarm to take pain meds at night and found out how painful it is when I got stuck on the toilet until I could gather enough oomph until I could get myself up).

I seem to have reached a plateau.

I have been taking 1-2 of the vicodin 5-325 mixture. I called the nurse on Monday and I could tell I was being treated like a suspected drug addict. The P.A., Tracey told me I could take two at a time because I will be in a lot of pain. The nurse I spoke with couldn't find his note right away and accused me of taking it wrong. I corrected her right away and said Tracey told me I could take 2 if needed and that he wasn't writing me a new script for it, because I have some at home. She said there was nothing stronger they could give me. I am not sure if they couldn't because of the type of surgery or if their policy is not to give out anything stronger than vicodin.

It feels like someone has stuck a fork in my back and it is stuck there. In the front and side, it feels like there is a crowbar sticking in me. Coughing is absolutely horrible. The lower left lung where they took the plum sized mass out hurts like heck when I cough. I have been bracing myself when I cough with both hands, tried holding a pillow against my chest, nothing seems to help.

Raising  my arm just sucks and gives me the most extreme pain that lasts a long time before it goes away. and I get so mad when I do whatever it is that makes it do that.

I am still sleeping in the recliner at nights, but found that I can lay on my right side on the sofa now.

It is a darn good thing the mass was as big as it was or I would be getting mad that the surgery and pain was not worth it.

 Thanks for listening and if any of  you had this surgery, what did you have for pain relief when you got home?

coco2008's picture
coco2008
Posts: 406
Joined: May 2013

Bless your heart.  I'm sorry you are going through all this.

I can't help you, but I can certainly pray for you.

Love and gentle hugs,

Sandy

jnl's picture
jnl
Posts: 3873
Joined: May 2009

After reading your post, I don't even know what to say except how very sorry I am.  I cannot imagine what you are going through now. 

I've heard that your surgery is the most painful, so, I am sure you need the pain pills.  Just be sure and use a stool softener as pain meds tend to constipate us.

Lots of hugs,

Leeza

SIROD's picture
SIROD
Posts: 2116
Joined: Jun 2010

Percocet and talk with the surgeon and explain your pain.  Don't bother with the other office people.  You do need something stronger.

Best,

Doris

Double Whammy's picture
Double Whammy
Posts: 2259
Joined: Jun 2010

I'm so sorry to read this update. One way to get some help might be to show up in the emergency room.  If your pain is not relieved by pain meds, they're not working.   I so hope you get some relief and soon.  My friend had a broken arm and had surgery and she needed pain meds a little longer than the orthopedic surgeon wanted to prescribe them.  She is not/was not addicted.  She could not sleep because of the pain and she was extremely cranky because she was tired and in pain all the time.  But the ortho said she'd had enough and she should be just fine on Tylenol.  She went to her primary care physician who gave her a script that she took until she didn't need it anymore.  This may be "drug seeking behavior", but doggone it, it sounds like you need some help. 

Sending hope for relief.

Suzanne

mom62
Posts: 600
Joined: Mar 2004

Hi,

Although it was not my lung I had surgery 4 years ago that was similar to what you are saying.  I had 3/4 of my sternum removed and part of three of my ribs.  What you have to realize is that the pain will be intense for a little while.  I was in the hospital for 10 days and then it was about 3 to four weeks before I started feeling better.  It will probably take about 6 months to get all your strength back.  I took 2 pills every four to six hours after I was released from the hospital, that is what they told me and what was on my script.  You are not taking the medication for the fun of it you are taking it to relieve pain don't let anyone make you feel bad about that.  Coughing, sneezing and laughing will require you to have a pillow handy to hold to your chest.  It is like having open heart surgery, you won't recover overnight but you will recover.  Make sure you take a stool softner pill every day so you don't get constipated.  (sorry if I'm grossing you out).  I wish you well and hope you heal fast.  I too slept in the chair for about a week, and when I went into the bed I would wake my husband to push me up when I needed to go to the bathroom at night.  Try to use your legs and not your chest to lift yourself up, try putting your hands behind your knees and pull on your legs to help you get up.  It helped me.  It is hard and does get you down when you can't get comfortable and do things but you need to take it easy and keep taking your medication on time.  Hope this helps.

Terry

 

New Flower
Posts: 3914
Joined: Aug 2009

I am really sorry. I think you need sothing stronger too. Terry gave you good suggestion. You have been very brave and amazing figter. please keep going you will see better days very soon

Sending positive thoughts for quick healing. 

SIROD's picture
SIROD
Posts: 2116
Joined: Jun 2010

You have had lots of good suggestions, do keep us posted on what is happening with you.  I hope that you found someone to help you.

Best,

Doris

SIROD's picture
SIROD
Posts: 2116
Joined: Jun 2010

Wondering how you are doing?

 

Doris

cinnamonsmile
Posts: 1042
Joined: Dec 2010

Hi Doris, thanks for asking. I had made an update in a new thread called turned a corner or something like that. but tonight i am so so sore.

 

CypressCynthia's picture
CypressCynthia
Posts: 3873
Joined: Oct 2009

You on a low dose of vicodin (5 mg hydrocone with 325 mg of tylenol).   I would not hesitate to take two or ask for more.  The physician can certainly give you a stronger pain med.  Tracey is incorrect.  For example, percocet (oxycodone) is stronger than vicodin. 

I would call the physician and ask him what to do. And, if the office "nurse" is making you feel uncomfortable about asking for pain relief, please report her to your doc!  I doubt she is an RN based on her ignorance.

Pain management is not just important because it relieves pain, but it also helps you heal faster (when you are more comfortable, you move more and that equals less side effects and faster healing).

What you will have to watch for as you go up on your dosage are more side effects: nausea, constipation, fatigue.  You may need something for the nausea and constipation.

Also, tylenol (acetaminophen) can be toxic on your liver.  If you take two, you are taking 500 mg of tylenol (acetaminophen).  I would try and stay less than 3000mg total per day.

Keep a pen and notepad near you and note times that you are taking your meds.  If I don't do this after surgery, I can't remember when I took the last dose because I get loopy.

I don't know if you can take NSAID's (aspirin, aleve, advil, etc.) yet.  They can increase the risk of bleeding, so don't take them unless ok'd by your doc.

There is a pain med equivalent chart with morphine used as the gold standard.  If you look at it, you can see oxycodone is 1.5-2 X stronger than oral morphine or hydrodocone (vicodin).  See chart: http://en.wikipedia.org/wiki/Equianalgesic#Morphine-centric_chart

I am so sorry you are going through this and hope you feel better soon!  If not, I would go to the ER if pain persists  Prayers and hugs!!!!

cinnamonsmile
Posts: 1042
Joined: Dec 2010

Thanks Cypress.  I also think it was disgusting that they won't give me something stronger.

I am taking 1-2 Vicodin 5-325 every four hours when I am awake. I was setting my alarm to wake up and take one twice during the night, but I am now down to one at night. I set the alarm about 4 hours before I want to wake up.

I will certainly bring up your point of if I am in less pain, I will heal faster and explain like exactly how you wrote.

But by now, I am not sure if percoset/oxy is needed. But then again maybe once or twice when I am up I take two vicodin.

I think I see the surgeon next week. I am certainly going to bring up the subject on how poorly my pain management was handled.

Do you think demanding stronger pain meds two weeks post surgery is still within the time frame for stronger pain meds?

 

CypressCynthia's picture
CypressCynthia
Posts: 3873
Joined: Oct 2009

If you are getting by on the two (10 mg hydrocodone), I would not switch.  Personally, percocet makes me sooooo sick and I have never, ever been able to take anything stronger orally than hydrocodone.  

It sounds like you needed much better discharge teaching.  I was given the 10mg hydrocodone (not the 5) after my back surgery and advised to take two every 4-6 hrs.  That is 4 X the opiate strength that you were prescribed and opiates are the gold standard for pain control.

I do not know usual pain doses after a thoracotomy, but, if you are in pain, and it is postsurgical and not chronic pain, why would they give you a hard time?

"Inadequate post-operative pain relief may result in clinical and psychological changes that may increase the morbidity and mortality as well as the cost of treatment as a whole, in addition to decreasing the quality of life post-operatively. It may be associated with deep vein thrombosis (DVT), and pulmonary embolism, pneumonia, delayed wound healing and demoralization.[1] Realizing the problems of unrelieved acute pain, Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has recommended standards of pain management, especially with regard to assessment, monitoring and treatment." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3106378/

As you have figured out, it is important to take the meds fairly regularly while you are having the pain.  Mild to moderate pain is controlled much better by pain meds than severe pain.  If you let yourself get in severe pain, it is kind of like chasing your tail.   You will take more with less result.   Pain is usually worse in the afternoon and evening, so anticipate that for awhile.

When you can take an NSAID (aspirin, aleve, advil, etc), that group of drugs can help more with inflammation, which can add to pain.  But do NOT take them without surgeon's ok because they can cause bleeding.

Good luck!!!  And I am so happy that you are feeling a little better.

aisling8's picture
aisling8
Posts: 1245
Joined: Feb 2010

I had no idea this was such a whopper of a surgery. And it's such a shame that you're having to fight for relief. 

Hoping you continue getting better.

xoxo

Victoria

cinnamonsmile
Posts: 1042
Joined: Dec 2010

I had finished up the bottle of 5-325 hydrocodone-acetimnophen that the pain doctor had prescribed in May 2013. I had forgotten that that the pain dr.'s nurse practioner had given me a new script for vicodin and that I had dropped it off. It was a big surprise when I picked some other meds and I got that bottle with my current meds. I never looked at the bottle. She had changed the script. She gave me a script for 5-500 hydrocodone-acetimenohpen. Well that certainly wasn't going to work for this current pain.

I called the surgeon's office for more vicodin. I got the same medical assistant and the same attitude that I was a drug addict. She said she would get in touch with the PA, but that him and the surgeon were in surgery (they do surgeries everyday).

Well, they gave me the 5-325. They gave me 30 pills and wrote that I can take them once every 6 hours. I am still having a lot of pain. I don't think that they realize that pain is worse when they cut into areas that are already nerve damaged. 

Also, I think they think that I take vicodin all the time, which is NOT the case. The PA chose to discuss my regular pain management while I was in the hospital on my discharge day. Yeah, like I could think clearly and explain things clearly and accureately. I hardly ever take vicodin. And the ONLY reason I had ANY was because I had gone too far past the due date for my Lidocaine infusion so that when I had my trial for the spinal neurostimulation trial for pain at the end of May/June, I was at peak pain and could see how it delt with that. Otherwise I don't take it. Tramadol seems to do fine.

I really don't know how to explain this to the surgeon (who I guess patients NEVER get to talk to directly). Heck, I can't even talk to the PA (cept on a Sunday when he was paged to answer my call because I was coughing up blood).

Can anyone help me think clearly to write it down in a letter to explain things without sounding like a drug addict/over emotional patient? Well, I am an over emotional patient from how they are treating my pain post surgery.

I have now learned another thing to add to my presurgical questions: How do you plan on treating my post surgical pain? I think that is a good question that a lot of us should ask to avoid situations like mine.

Also CC...thanks for helping with the dosages. The tylenol component doesn't even help nerve damage pain so I don't know why the nurse practitioner would even up that amount to 500 on this last script. I take enough drugs on a regular basis that I don't need the extra acetimenophen doing any liver damage.

My Pain is even worse today because I took one of the 5-500 vicodin at 7:30 am and it said I could only take one every 12 hours. The pain has been so bad, I had to cheat and take another 5-325 vicodin at around 3:30/4 pm. Because I can't take a 5-325 about every 5 hours now because the surgeon's office only gave me 30, I have to wait til bedtime to take on 5-500 and one 3-325. I hope I get some sleep tonight. I slept terribly last night, waking up in pain all the time. The pain is out of control and I simply don't have enough pain meds to get it under control because I am afraid I will run out cuz I only have enough to take three 5-325 vicodin a day and will run out in ten days.

I have a questions, would it be better to go to the Emergency Room during the day when the surgeon is around, or wait and take an ambulance in the evening after surgeon's have gone for the day?

Thanks for all your help. I am crying, tired, exhausted, full of pain, worried, mad, and just can't think straight.

VickiSam's picture
VickiSam
Posts: 8219
Joined: Aug 2009

Please know that so many of us are keeping you close in our hearts - and prayers are going out to you 24 hours a day, 7 days a week.  Kiss

 

Vicki Sam

cinnamonsmile
Posts: 1042
Joined: Dec 2010

Well, I have the pain under control today but I am being very very careful not to do too much. I am really taking it easy and not worried about the cupboard full of dishes!

tufi000's picture
tufi000
Posts: 436
Joined: Jun 2005

Please glue yourself to that recliner today! The dishes can wait, the veggies can wait, Brian can wait.  I know it is very difficult for a constant accomplisher like you to sit still, but ya gotta do it right now babe or you wont heal.  Glad to see today is better than yesterday.

Remember no guilt about not doing!!!!!!  love ya

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